Obama Medicare Cuts Target Providers, Then Beneficiaries For Savings

tpsbmam

(1000+ posts) Send PM | Profile | Ignore

Mon Sep-19-11 04:00 PM
Original message

Obama Medicare Cuts Target Providers, Then Beneficiaries For Savings

Edited on Mon Sep-19-11 04:04 PM by tpsbmam

President Obama wants to extract $320 billion in savings from the health care system in his push to trim the deficit, starting with cutting payments to Medicare and Medicaid providers and ending with making beneficiaries pay more.

The biggest savings -- $135 billion over 10 years -- would come from letting Medicare pay for drugs at the same rates as Medicaid, which enjoys much greater rebates on generic and brand-name drugs.

The next largest source of savings -- $42 billion -- would come from nursing homes, rehab centers and long-term care facilities, which the administration thinks can be encouraged to be much more efficient in providing care right after people get out of hospitals.

Okay, good thing on the drugs, even better if we could reimport them. As for the rest.... Mr. President, have you ever worked in Physical Medicine & Rehab? I have -- I've worked in rehab in 4 hospitals and none were inefficient. And they work pretty much the same as any CARF accredited free-standing rehab facility, some of which are OUTSTANDING and do excellent jobs at getting people back to living independently, working if they can, and so on. We moved people through as rapidly as we safely could -- we were pressured by insurance companies, Medicare & Medicaid like anyone else, among other things. Sorry, Mr. Pres, but you have your head up your ass here. I can't speak to nursing homes and long-term care facilities but frankly, I hate to think what cutbacks would do to some operating on the edge anyway.

They're stressing that none of this will hit the folks currently on Medicare -- much of it wouldn't kick in until 2017 and after. I don't think they're planning for 65-year-olds to die fast -- there are 90-year-olds alive today who'll be here in 2017, for pete's sake! So it must mean it'll only apply to new Medicare recipients after 2017. (My generation...thanks so much.)

Some of the things being considered: $100 copays for home healthcare visits! Having had elderly parents and many elderly patients, home care visits are necessary if a person is going to stay at home and has complex medical conditions. They may not require more than isolated periodic visits, but needing a few days of visits would be unaffordable for many people -- this would end up being a service only for the well-to-do....again. This is the kind of thing that dooms people to nursing homes. A $25 increase in deductibles for doc visits. This is going to stop some people from going to the doctor for preventative care -- $25 is a lot when you're barely subsisting. "Charging an extra 15 percent premium on people who have especially generous Medi-gap plans," (WTF is an "especially generous" plan?). Raising premiums by about 15% for folks whose income is over $85,000/year. Okay, I can live with this one, though I'd make it a gradual increase...e.g., 5% at $85,000.....10% at $125,000....etc.

Oh, and ETA once again, cuts to providers results in fewer services and providers available to patients. It's shown itself time after time. To give a personal example, my services in the hospital were charged out at about $125/hour (it changed over time). Medicaid reimbursed the hospital $13/hour. We saw all Medicaid inpatients but were limited as to the number of Medicaid outpatients we could accept because of this. That was true all over the hospital.

More at the HuffPo article.

I say leave Medicare, Medicaid, Social Security, LIHEAP, etc etc alone. Cut the damn military budget in half and raise taxes on the rich and corporations and voila.....problems solved.